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Trastuzumab concurrent with chemotherapy improves DFS in HER-positive breast cancer
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San Antonio Breast Cancer Symposium
Results from a phase-3 trial suggest that trastuzumab is more efficacious when administered concurrently with chemotherapy, rather than sequentially.
Edith A. Perez, MD, director of the breast cancer program at the Mayo Clinic in Jacksonville, Fla., said proper administration of trastuzumab (Herceptin, Genentech) improved event-free survival, recurrence-free survival and disease-free survival.
“Based on a positive risk/benefit ratio, we recommend that adjuvant trastuzumab be incorporated in a concurrent fashion with taxane chemotherapy,” she said. Perez, who is a member of the HemOnc Today Editorial Board, presented the results at the CTCR-AACR San Antonio Breast Cancer Symposium.
Researchers randomly assigned 1,087 women to chemotherapy alone (arm A), 1,097 women to chemotherapy followed by trastuzumab for 52 weeks (arm B) and 954 women to chemotherapy and concurrent trastuzumab (arm C).
After adjustment for possible confounding variables, they found that DFS increased from 71.9% in arm A to 80.1% in arm B after 5.5 years of follow-up.
In the second comparison, researchers observed superior DFS for patients in arm C (84.2%) compared with arm A (79.8%).
“There is a statistically significant 33% reduction in the risk of an event with the sequential addition of trastuzumab following ACT chemotherapy,” Perez said. “There is a strong trend for a 25% reduction in the risk of an event with starting trastuzumab concurrently with taxane relative to sequentially.” – by Jason Harris
For more information:
- Perez E. #80. Presented at: the 2009 San Antonio Breast Cancer Symposium; Dec. 8-12, 2009; San Antonio, Texas.
For a number of years now, we have recognized that trastuzumab is a very important component of the therapy for HER-positive adjuvant breast cancer and there have been different models for its use; one giving it concurrently with taxane-based chemotherapy for a year and the other where trastuzumab is administered after chemotherapy is completed. The trial that Dr. Perez presented gives us evidence that there is a greater effect if you give trastuzumab concurrently with chemotherapy. That’s a very important finding in terms of practice.
–Claudine Isaacs, MD
Director of the
Clinical Breast Cancer Program , Lombardi Comprehensive Cancer Center
